Therapy with Irene

Please share 2-3 anonymized examples of how the work can play out and/or look in the room so that I can form a visual or narrative of what to expect.

Example 1: A young woman came to see me because she felt like she “messed up” every relationship she had. She was sure she just didn't know what she was doing wrong because she had not learned to “act right.” While “Sarah” was in such a self-blaming place, she could not look at what was happening. She eventually worked towards softening the self blame, just enough, so she could objectively look at what was happening. This new objective view allowed her also to see what the other person’s role was in the failed relationship.

We are now working on her seeing her value as well as what are the essential parts of who she is. She is seeing that she is not what other people say she is. She is working on valuing her unique qualities that make her who she is. She is seeing that she can adjust her interactions if she approaches herself gently and with compassion. It is easier to learn, grow and change in an environment of self love and self respect.

Example 2: An older gentleman came to me for help with his hoarding. He was deeply troubled and ashamed of his hoarding. He was so focused on wanting to force himself to “clean out” that he did not see the other very wonderful and talented parts of himself. He is a talented artist, but he could not allow himself to acknowledge this talent, explaining, “because I can’t clean up my mess.” Before retiring he had been a loved and gifted teacher. He has an innate ability to make other people feel heard and good about themselves. He was lonely and wanted to be in a relationship. He would not let himself even entertain the idea of dating until “I clean up.”

Over time he came to understand that his hoarding was a part of himself and that one behavior did not define him. I educated him about the research on hoarding which informs us there is no agreement on the cause or the treatment of hoarding. In the end we were not able to get him to “clean up,” but he did develop an appreciation of his many wonderful qualities. He was able to accept that he was not just a “hoarder.” He made the positive decision to sign up on a dating site.

Are there any philosophies or values that inform your work that I should know about?

I believe in social and economic justice. I believe that everyone has value regardless of race, physical attributes, abilities or disabilities, education, or intellectual levels. I accept and affirm people of all sexual orientations as well as transgender and sexual non-conforming people. I am open to hearing how you live your life and I am not judgmental.

How much do you share about yourself during our time together and why?

I am willing to share some things about myself, but the session should be about you, not me. I will offer my opinions, and I will share my reactions, if asked.

Some people have the mistaken idea that the therapist has to be just like them in order for the therapist to understand them. Some clients will ask questions to see if the therapist is like them. The reality is we are all different. Even if you and I have been through the exact same situation, we will each have our own reaction to that situation. Some people wish that the therapist is like them so they will not have to explain and describe as much. This wish, though understandable, misses the value of you “telling” your story. Having the therapist “witness” your experience, with you, is part of the healing process.

How participatory are you during sessions?

There is no hard and fast rule here. Many times, when clients come in for the first few sessions they have a lot of emotions that have been bottled up, and they need to talk, and I need to actively listen. As time goes on and I get to understand what issues you are dealing with, I will point out patterns, themes and common threads. I always encourage you to give me feedback about how things are going.

Do you assign homework, activities, or readings for me to do between sessions? Why or why not?

If you ask for this I can provide readings. We will work together on learning to observe yourself and your feelings between sessions. If you want to keep a journal, I welcome this; you can bring the journal in and share it with me.

How will our relationship be different than relationships I have with friends/loved ones?

I am trained on how and what to listen for. A friend will give you advice that you may or may not find helpful. I will help you figure out for yourself what you want and how you can make the change that you seek happen.

Is there ever a time when you would encourage me to leave or graduate? Or how do I know when it’s time to end or move on, or time to stay and explore more?

I allow you to decide this. If you want to leave, I do not try to hold you back. However, I do hope you will take time to review the work we have done. I hope you will look at the gains you have made. I would like you to be clear on why you are leaving and aware of what issues might require some attention in the future. If and when you choose to return, I will welcome you back. I understand and accept that sometimes people come and go.

Where did you work before going into private practice?

I worked in several community-based mental health clinics with all ages.

Have you received any particular training beyond your post-Bachelor’s training?

I have a master’s degree in social work from Hunter College. I graduated in 1985, and I am a New York State Licensed Clinical Social Worker.

Beyond graduate school, I’ve continued to learn and improve my skills. I have received training in different schools of thought: psychodynamic, Internal Family Systems (IFS) and Cognitive Behaviour Therapy (CBT). I have also received training in issues such as racism, sexism, LGBTQ and trauma. I have extensive training in the field of aging, as well as death and dying.

Psychodynamic theory is the underpinning of my understanding of human nature. The best way to explain what psychodynamic psychotherapy is is to use the metaphor of a house. You are like a house, a structure (you today) with a foundation (your past). Things that happen to you as a child are what formed who you are today. Things you experienced, felt and thought are the foundation of your house/self. As a young child you figured out the best ways to cope and navigate through your life. These ways of coping become patterns that carry over into adulthood. They affect your behavior, thoughts, beliefs and mood. These patterns may or may not work for you as an adult. As you begin to notice your patterns, you become self-aware. As your awareness grows you can change the patterns that are not working for you. This awareness helps you to make better life choices. Being aware helps you build on your strengths and change the parts of your life that you are unhappy with. This results in you becoming the person you most want to be.

What led you to become a mental healthcare practitioner?

I want change personally, politically and globally. I want the world to be a better place.

What is the best part of the work for you?

When you trust me enough be open with yourself and me. There is nothing more magical than speaking to you in the language of your inner world.

What is unique about the work you do, or how have you found your work to be different than your colleagues’?

I believe there are many caring and talented therapists out there. I am intuitive, warm and nonjudgmental. People have told me I am easy to speak to.

How do you approach diversity in the room or working with clients who may come from a different background than you?

I acknowledge differences right from the beginning and I am open to hearing if you think I am not “getting” you. I am very comfortable telling you when I sense I do not understand what your experience is.

How can you tell if I am benefiting from working with you?

I see change. I see changes in behavior, mood and thought process. If you are not sure, I welcome discussing this with you.

How can you tell if I am feeling stuck, unseen, or unheard?

I ask. I look for feedback. I welcome hearing both what is not going well and what is going well. If I find you just reporting and not working, I will point this out.

How long should I commit to being in therapy, at least in the beginning?

Unless there is an immediate feeling that “this is not the right person for me,” I would suggest you give it three sessions.

I can’t say how long you should stay in therapy. You make your own decision about when you feel good enough to stop. I support your desire to leave when you feel good about where you are.

I welcome clients back when and if they want to return. Clients will sometimes do this for a short check in or if a new issue arises. I believe you should take what you need and move on when you are done.

How should I prepare for my first session with you?

Come in and tell me what is bothering you.

Do I need to bring anything with me?

Curiosity about yourself.

Do I need to be mindful of anything in particular while commuting to your office?

Everyone is scared in the beginning. This is natural.

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